MR Neurology Perfusion Maps - Numaris X JobAid

MR Neurology Perfusion Maps The MR Neurology Workflow is used to display and evaluate Perfusion weighted im- ages and calculate Perfusion Maps, such as PBP, TTP, relCBV, relCBF, and relMTT. These perfusion maps show different perfusion characteristics of the underlying tis- sue.  Note: MR Perfusion Dynamic Susceptibility Contrast (DSC) data set must be con- sistent and use either distortion-corrected or non-distortion corrected image data. 1. From the Patient Worklist, load the appropriate data set into the MR Neurology Workflow a. Examination correctly mapped: double click to load b. Manual mapping required: right click the examination and Open With > MR Neurology. @ Open Ctrl+O @ Open with Favorites View as Read-Only with - Suggested Batch Open MR Breast Assign Workflow MR BreVis Group Studies MR Cardiac Analysis * Search Patient with DICOM Q/R MR Neuro 3D Send to Archive Ctrl+Shift+S MR Neurology Add to Demo List MR Oncology * Remove from Demo List More Set Mark state Set Delete Protection state Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 SIEMENS Master Template: EFF Date 22 Aug 17 | HOOD/HILS HOOD05162002647849 Healthineers Jobaid: Effective Date: 02/07/2020| HOOD/HILS HOOD05162003063276 Job Aid | MR Neurology Perfusion Maps syngo.via Effective Date: 02/07/2020| HOOD/HILS HOOD05162003063276 2. Case Navigator > select Perfusion Maps icon a. New image layout opens MR Neurology MR Neurology Reading Single Perfusion Mismatch Mean Neurology Click Maps Eval. Curve Settings Viewing Pre-Contrast Post-Contrast 3D Series Parametric Maps 3. MR Neurology Reading Layout a. Left Screen: Viewing Segments i. Upper Left Segment: 4D Perfusion-weighted images ii. Upper Right Segment: TOF Images iii. Lower Left Segment: Global Bolus Plot (GBP) 1. Displayed as a reference (Grey curve) 2. Global AIF: segments also show the arterial input function (red curve) used for perfusion map calculations iv. Lower Middle Segment: 25 (AIF) signal-time curves only displayed for Global AIF 1. One for each voxel of the 5x5 ROI (From upper left segment) v. Lower Right Segment: Calculation options for Global AIF or Local AIF ... AHL MR_Neuro_Perfusion_A_AVM_1 NOR EL-ISLAM MR_Neuro_Perfusion_A_AVM_1 NOR EL-ISLAM 15yo Avanto 15yo *1/1/1995, M, 14Y SMRVB20A *1/1/1995, M, 14Y R.B15 CURRENT HFS CURRENT ep2d_perf_p2_MoCo +LPH TOF_3D_multi-slab latest/Phase_01 latest STUDY ID 2 STUDY ID 2 10/22/2009 10/22/2009 1:24:56 PM 1:09:40 PM 2 IMA 1 FRM 11 RHA F TR 1480.0 TP 0 TE 30.0 SP H26.6 TA 00.05 SL 5.0/1.5 FoV 230*230 TR 25.0 BW 1345.0 TE 7.0 p2 MAGN/NAVAIL/MOCO 128p*128 SP H2 Cor(-4)>Sag(-1) MIP : MIND A1/PFP/FS Zoom 3.42 T:HE1-4 1258 A1/SAT1 *epfid2d1_128 / 90 634 f13d1r_170/ 25 Reference volume for motion correction No. of Timepoints: 50 | Arterial Input Function (AIF) Perfusion Maps Global AIF Local AIF V TTP PBP rel.CBF rel.MTT rel.CBV rel.CBVCorrected 4095 Perfusion Delay Correction BLS BLE Select Al Clear Al Start Close Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 2 of 7 Job Aid | MR Neurology Perfusion Maps syngo.via Effective Date: 02/07/2020| HOOD/HILS HOOD05162003063276 b. Right Screen: Additional Viewing segments NOR ELITLAM WOR EL EU 15Yo "1/992, M. 14 CHIPENT 12:59 11 PM 12:57:11 PM TH 70008 SP 126 5 TR 2800 0 TE SCO BN 1900 TA 00 04 3404129 EWY 1345D ADCAID CHFI-4 THE1-4 NOR CURIACHT EILOY ID 2 ETLOY 102 125416PM TE 94.0 BP H28 2 7400 04 TE MAO BWV 1245 8 DIFFITRACEYOND THE1-S 4. Lower Right Segment: select Tab for the required Perfusion Maps Evaluation method a. Global AIF: manual adjustment of input parameters for map calculation b. Local AIF: automated map calculation with standard parameters 5. Global AIF Method: manual adjustment of input parameters calculates maps a. Note: Global AIF manually defines the Arterial Input Function (AIF) curve in the lower left segment. Determines the position of the 5x5 ROI in the images and chooses the individual voxels considered for multi-selection, an average signal- time curve is then displayed b. Step 1 i. Scroll through the Perfusion Weighted Images ii. Select an image when contrast agent arrives in the region of interest iii. Drag ROI to region-of-interest, position ROI over arteries, and over smaller arteries that are not explicitly recognizable as vessels in the basic image iv. Lower Middle Segment: Signal-time-curves for reach voxel update accordingly AHR MR_Neurology CURRENT HAS ep2d_perfusion_MoCo latest/Phase_01 # 3091842101 STUDY ID 3091842101 2/19/2016 9:39:23 PM 2 IMA 1 FRM 7 RFA DAR TR 1490.0 TP O TE 32.0 SP H2.9 TA 01:37 SL 4.0/1 2 BWV 1500.0 FoV 220*220 NAVAL/MOCO 128 128 Tra>Cor(-5)>Sag(3) A1FFS Zoom 3.73 HEA;HEP 584 "epfid2d1_128 / 90 320 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 3 of 7 Job Aid | MR Neurology Perfusion Maps syngo.via Effective Date: 02/07/2020| HOOD/HILS HOOD05162003063276 c. Step 2 i. Lower Middle Segment: select curves of voxels that should be considered for the calculation for the perfusion maps ii. Select One Arterial Input Function (AIF) time-point (or) Depress Ctrl/Left mouse > select more than one AIF time-point 1. Note: curves with the flattest baseline and the deepest curve are most suitable 2. Note: number of AIF time-points is up to the Radiologist discretion iii. Lower Left Segment: result of selection is displayed as a red curve No of Timepoints 60 Arterial Input Function (AIF) FPe Select All Clear All d. Step 3 i. Calculation for Perfusion Maps > Lower Left Segment, drag lines to: 1. Beginning of Baseline 2. End of Baseline 3. End First Pass FPe Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 4 of 7 Job Aid | MR Neurology Perfusion Maps syngo.via Effective Date: 02/07/2020| HOOD/HILS HOOD05162003063276 e. Step 4 i. Check boxes to generate maps: TTP, relCBF, relCBV, PBP, relMTT Perfusion Maps ii. Delay Correction (Optional) 1. Block-circulate-deconvolution Global AIF Local AIF method for Global AIF (increases V TTP V. PBP calculation time) ¥ rel.CBF V. rel.MTT V rel.CBV Illl rel CBVCorrected 2. Considers different arrivals of contrast medium O 4095 3. Note: Only perform this step if Perfusion reference ROI is far away from Delay Correction ROI to be measured) f. Step 5 Start Close i. Select Start 1. Perfusion Tools area closes during map calculation ii. Progress Bar in Case Navigator shows status of calculation process iii. Maps are created iv. Findings created: creates a snapshot where the AIF was specified AHR Findings Navigator Mit_ Nourology MR_Naurology CURRENT HE'S CURRENT Name Value Source RELOCBY LOCAL ALPH Wond Maps_Perf ... MRN ... MR # 3091842101 # 309 842501 STUDY 0 3381842007 STUDY D 30918494000 2/19/2016 2/19/2016 9. 33:23 PM 1 M4 1 FRM 12 2 HA 1 FRM 12 RFA RFA FI AHR MR_Neurology TR 1 490 8 SP.H20.9 TRY490 0 18 320 SP 120 9 SL 4.01 2 18 32 0 TA 51:37 EL 40M 2 FOV-220.220 TA 01:37 BWV 1500.0 DWY 1500.0 FOV 2201220 SMRVE120A PERF/RCBV 12341 28 PERFITIP 128 1 28 CURRENT Zcom 3:35 ep2d_perfusion_MoCo HEATHER HEATER 30 latest/Phase_01 # 3091842101 STUDY ID 3091842101 2/19/2016 AHR 9:39:23 PM 2 IMA 1 FRM 7 MR. Neurology MR Neurology RFA F CURRENT RELMIT_GLOBAL ES. 0UB DAR 009-1842101 # 3091842408 STUDY D' 308184200 STUDY D 30998420110 TR 1490.0 TP O 219.2016 201 9/2016 TE 32.0 SP H2.9 SL 4.0/1 2 3 MA'J PRM 12 TA 01:37 BWV 1500.0 FoV 220*220 NAVAL/MOCO 128-128 RFA Tra>Cor(-5)>Sag(3) A1FFS Zoom 3.73 ET HEA;HEP W 584 'opfid2d1_128 / 90 320 TP O SP 120 9 TR 1490 0 SL 4.0M 2 TE 3200 TA DI: 3 Fov: 220:220 T4,01.37 128-123 EWY 1 5000 PERF.RCBY PERFATT Zoom 3:58 1914 ATIFS HEATHER optional _120 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 5 of 7 Job Aid | MR Neurology Perfusion Maps syngo.via Effective Date: 02/07/2020| HOOD/HILS HOOD05162003063276 6. Local AIF Method: automated map calculation using standard input parameters a. Step 1 i. Check boxes to create maps: TTP, relCBF, Perfusion Maps relCBV, relMTT Global AIF Local AIF ii. relCBV Corrected: includes a T1-correction V TTP PBP (considering special effects of contrast me- rel.CBF V rel.MTT dia) V. rel.CBV ¥ rel.CBVCorrected 4095 Perfusion Delay Correction b. Step 2 i. Select Start 1. Perfusion Tools area closes during Start Close map calculation ii. Progress Bar in Case Navigator shows status of calculation process iii. Maps are created MR_Neurology MR_Neurology Prisma RVB20A CURRENT IFS CURRENT TTP_ep2d_perfusion -LPH RELMIT_LOCAL_ep2 perfusion_MoCn latest latest # 3091842101 # 3091842101 STUDY D 30918421 STUDY D 3091842101 2/19/2016 2/19/2016 9:39:23 PM 9:39:23 PM 1 IMA 1 FRM 12 4 IMA 1 FRM 11 RFA REA FJ TR 1490.0 SP H28.9 TR 1490.0 TE 32.0 SL 401 2 TA 01:37 SL 4.0/1 2 TE 32.0 TA 01:37 BVV 1500.0 FoV 220'220 128-128 VV 1500.0 PERF/TTP Cor(-5)>Soo(3) PERFAMATT AUFS Zoom 3.71 62 AIFS HEA HEP HEA HEP epfic2d1_128 /90 septid2d1 128 /90 MR _Neurology MR Neurology CURRENT CURRENT RELCBY_LOCAL_ep2d_per RELCOF_LOCAL_ep2d_pe Latest latest 4 3091842101 # 3091842101 STUDY D. 3091842101 STUDY D 3091842101 2/19/2016 2/19/2016 9:39:23 PM 9:39:23 PM 2IM41 FRM 11 3 IM4 1 FRM 11 RFA RFA F TR 1490.0 TP O TR 1490.0 TP O TE 32.0 SP H23.7 SP H23.7 SL 4.0/1 2 TE 32.0 TA 01:37 TA 01:37 SL 4.041 2 BVV 1500.0 FoV 220 220 128'128 W 1500.0 PERFRCBY Tras Cor(-5)>Sag(3) PERFIRCEF Troy Cor(-5) Sac(3) A1/FS Zoom 3.71 ALFS HEA, HEP 561 Ceptio2d1_128/90 290 HEA HEP 4Epfid2d1_128/90 7. Save Results Save and Send: Results are stored on the system and sent to your archive II Save and Pause: Results are stored on the system Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 6 of 7 Job Aid | MR Neurology Perfusion Maps syngo.via Effective Date: 02/07/2020| HOOD/HILS HOOD05162003063276 Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (herein- after collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2018 ………………………………………………………… Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens.com/healthineers Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2018 Page 7 of 7